There are not enough child care workers or facilities to meet demand.
The lack of affordable child care options negatively impacts job opportunities, especially for women and low-income families.
States have employed a variety of policies to improve child care access, but there are limited studies looking at how specific approaches affect access.
The COVID-19 pandemic disrupted child care for 93% of working families in Missouri; about 1 in 3 could not access any child care providers [United WE, 2020 & 2021].
The capacity of licensed facilities. 27% of families use child care homes or centers [US Chamber Foundation, 2021]. There are 57 child care slots for every 100 children whose parents work [Child Care Aware, 2020].
Recruitment and retention of qualified child care workers. Missouri requires that child care facilities have at least one teacher for every ten children over two years old; state law requires one teacher for every four children under two (5 CSR 25-400). As a result, a small number of families are primarily responsible for subsidizing teacher and facility costs [Build Initiative, 2021].
Wages, facility-specific standards, and waiting periods for background checks can influence who is willing and able to fill these positions.
Individual facilities may choose to require additional educational qualifications, such as elated courses, degrees and/or credentials. While additional training can increase teacher quality, facilities are not required to increase salaries for this experience [CCSA, 2022]. 
Since the start of the COVID-19 pandemic, 31% of families said child care issues slowed their return to work and limited other employment opportunities (Figure 1) [US Chamber Foundation, 2021].
The cost of child care can equal or surpass parent salaries.
Child care access is determined by several factors e.g., social networks, income, state policies, and employer benefits. Most studies are focused on establishing a basic picture in terms of access, quality, and affordability of child care [Child Care Aware, 2020]. Therefore, it is unclear how specific policy decisions will impact child care access especially due to the varied reasons for limited child care access.
Common policy options that states can use to increase access to child care include:
Supplemental Table 1 highlights examples of state and federal approaches to improve child care access.
Ashcroft, J. (2022, 4). Rules of Department of Elementary and Secondary Education Division 25- Office of Childhood Chapter 400- Licensing Rules for Family Child Care Homes [Code of State Regulations]. Missouri Department of Elementary & Secondary Education. Retrieved October, 2022, from https://www.sos.mo.gov/CMSImages/AdRules/csr/current/5csr/5c25-400.pdf
Child Care Aware of America. (2020). Child Care Data Center Review. Child Care Aware. Retrieved October, 2022, from https://www.childcareaware.org/child-care-data-center/
Child Care Aware of Minnesota. (2021). Child Care Stabilization Grant Program - Child Care Aware MN. Child Care Aware of Minnesota. Retrieved October, 2022, from https://www.childcareawaremn.org/providers/child-care-stabilization-grant-program/
Child Care Aware of Missouri. (2020, August). Child Care Landscape in Missouri [Report]. https://mochildcareaware.org/. Retrieved October, 2022, from https://mochildcareaware.org/wp-content/uploads/2020/08/Child-Care-Landscape-Data-Report-Full-Report.pdf
Connecticut Office of Early Childhood. (2022, April 11). Child Care Program Stabilization: Frequently Asked Questions. Connecticut Office of Early Childhood. Retrieved October, 2022, from https://www.ctoec.org/covid-19/ready-set-rebuild/stabilization-funding/faq/
Department of Social Services. (2022, 10 01). Benefit Program Limit Chart. Missouri Department of Social Services. Retrieved October, 2022, from https://mydss.mo.gov/media/pdf/benefit-program-limit-chart
Department of the Treasury Internal Revenue Service. (2017, December). Credit for Employer-Provided Childcare Facilities and Services [Form 8882]. IRS. Retrieved October, 2022, from https://www.irs.gov/pub/irs-pdf/f8882.pdf
Dichter, H., & LiBetti, A. (2021). Improving Child Care Compensation Backgrounder. The BUILD Initiative. Retrieved October, 2022, from https://buildinitiative.org/wp-content/uploads/2021/12/Compensation-Backgrounder-12-13-21.pdf
Dicke, R., Johnson, E., Nahach, S., Ressel, K., & Institute of Public Policy, Harry S. Truman School of Public Affairs, University of Missouri. (2020, November). The Status of Women in Missouri [A summary report to United WE]. United WE. Retrieved October, 2022, from https://static1.squarespace.com/static/545815dce4b0d75692c341a8/t/5fad50a748fd365a1081d2c8/1605193896839/United+WE+Status+of+Women+Report+Final+11.11.2020.pdf
Early Childhood Education. (2022, April 28). New Mexico leads the nation as Governor Lujan Grisham makes childcare free for most families. Office of the Governor Governor Michelle Lujan Grisham. Retrieved October, 2022, from https://www.governor.state.nm.us/2022/04/28/new-mexico-leads-the-nation-as-governor-lujan-grisham-makes-childcare-free-for-most-families-2/
EPIC. (2022). Employer-Based Child Care Design Lab [flyer]. EPIC Executive Partnering to Invest in Children. Retrieved October, 2022, from https://www.coloradoepic.org/wp-content/uploads/2022/04/EPIC-Design-Labs-Flyer-4-28-22-FINAL.pdf
First Five Nebraska. (2021, December 9). Child care professionals: Apply now for the School Readiness Tax Credit. First Five Nebraska. Retrieved October, 2022, from https://www.firstfivenebraska.org/blog/apply-school-readiness-tax-credit/
First Five Years Fund. (2020, April 14). Child Care & COVID-19: Unemployment Benefits in the CARES Act. First Five Years Fund. Retrieved October, 2022, from https://www.ffyf.org/child-care-covid-19-unemployment-benefits-in-the-cares-act/
Georgia Dept of Early Care and Learning. (n.d.). Resources for the Georgia's Pre-K. Georgia Dept of Early Care and Learning Bright from the Start. Retrieved October, 2022, from http://www.decal.ga.gov/documents/attachments/AsstTeacherApprovedCredentials.pdf
Iowa Department of Human Services. (2020, 2 17). Child Care Eligibility Requirements. Iowa Department of Human Services. Retrieved October, 2022, from https://ccmis.dhs.state.ia.us/ClientPortal/ChildcareEligibilityInfo.aspx
Jacoby, G. (2022, September 9). State Family and Medical Leave Laws. National Conference of State Legislatures. Retrieved October, 2022, from https://www.ncsl.org/research/labor-and-employment/state-family-and-medical-leave-laws.aspx
Louisiana Department of Education. (2018, January 1). School readiness Tax Credits (SRTC) - GUIDance. Louisiana Believes. Retrieved October, 2022, from https://www.louisianabelieves.com/docs/default-source/early-childhood/school-readiness-tax-credits-(srtc)-guidance.pdf?sfvrsn=3
McLean, C., Austin, L., Whitebook, M., & Olson, K. (2020). Early Childhood Workforce Index. Berkeley, CA: Center for the Study of Child Care Employment. Retrieved October, 2022, from https://cscce.berkeley.edu/workforce-index-2020/report-pdf/
Minnesota Department of Education. (2022). Early Learning Scholarships Program. Missouri Department of Education. Retrieved October, 2022, from https://education.mn.gov/MDE/fam/elsprog/elschol/
Missouri Budget Project. (2018, March). Strengthen Childcare Assistance to Increase Access to Quality Care [report]. Missouri Budget Project. Retrieved October, 2022, from https://www.mobudget.org/strengthen-childcare-assistance-increase-access-quality-care/
Nebraska Department of Health and Human Services. (2022, 10 1). Child Care For Parents. Department of Health and Human Services. Retrieved October, 2022, from https://dhhs.ne.gov/Pages/Child-Care-Parents.aspx
North Carolina Department of Health and Human Services. (2022). NC Child Care Stabilization Grants. NC DHHS: Division of Child Development and Early Education. Retrieved October, 2022, from https://ncchildcare.ncdhhs.gov/Home/Stabilization-Grants
Office of Child Care. (2022, May 23). FY 2020 CCDF Data Tables (Preliminary) | The Administration for Children and Families. The Administration for Children and Families. Retrieved October, 2022, from https://www.acf.hhs.gov/occ/data/fy-2020-ccdf-data-tables-preliminary
Smart Start. (n.d.). Frequently Asked Questions | Smart Start & The North Carolina Partnership for Children. North Carolina Partnership for Children. Retrieved October, 2022, from https://www.smartstart.org/about-smart-start/faqs/
State of Minnesota. (2022). Sec. 245A.14 MN Statutes. Office of the Revisor of Statutes. Retrieved October, 2022, from https://www.revisor.mn.gov/statutes/cite/245A.14
United We. (2021). Missouri Town Halls [Report]. United WE. Retrieved October, 2022, from https://static1.squarespace.com/static/545815dce4b0d75692c341a8/t/61af9a2e74a8ae4e06efa4b5/1638898228026/UW_MOWomenTownHall_report.pdf
U.S. Bureau of Labor Statistics. (2022, March 31). Missouri - May 2021 OEWS State Occupational Employment and Wage Estimates. Bureau of Labor Statistics. Retrieved October, 2022, from https://www.bls.gov/oes/current/oes_mo.htm#00-0000
U.S. Chamber of Commerce Foundation & Missouri Chamber of Commerce. (2021). Untapped Potential in MO How Childcare Impacts Missouri's Workforce Productivity and the State Economy [Report]. U.S. Chamber of Commer Foundation. Retrieved October, 2022, from https://www.uschamberfoundation.org/sites/default/files/EarlyEd_MISSOURI_2021_DIGITAL.pdf
Viser, C., Camacho-Craft, I., Dutta-Gupta, I., & Grant, K. (2021, February). The Implications of Unmet Child Care Needs for Unemployment Assistance & Paid Leave Access during the Covid-19 Pandemic [Brief]. Georgetown Law Center on Poverty and Inequality. Retrieved October, 2022, from https://www.georgetownpoverty.org/wp-content/uploads/2021/05/No-Choice-Unmet-Child-Care-Needs-May2021.pdf
Washington State Department of Children, Youth & Families. (2021, May 13). Washington Becomes First in the Nation to License Outdoor, Nature-Based Child Care | Washington State Department of Children, Youth, and Families. Washington State Department of Children, Youth & Families. Retrieved October, 2022, from https://dcyf.wa.gov/news/washington-becomes-first-nation-license-outdoor-nature-based-child-care
